Spectral entropy as a monitor of depth of propofol induced sedation.

Hdl Handle:
http://hdl.handle.net/10147/209208
Title:
Spectral entropy as a monitor of depth of propofol induced sedation.
Authors:
Mahon, Padraig; Kowalski, Robert G; Fitzgerald, Anthony P; Lynch, Elaine M; Boylan, Geraldine B; McNamara, Brian; Shorten, George D
Affiliation:
Department of Anaesthesia and Intensive Care Medicine, Cork University Hospital, , University College Cork, Cork, Ireland. rsimahon@hotmail.com
Citation:
J Clin Monit Comput. 2008 Apr;22(2):87-93. Epub 2008 Feb 6.
Journal:
Journal of clinical monitoring and computing
Issue Date:
3-Feb-2012
URI:
http://hdl.handle.net/10147/209208
DOI:
10.1007/s10877-008-9109-0
PubMed ID:
18253846
Abstract:
OBJECTIVE: The aim of this prospective, observational study was to evaluate State and Response entropy (Entropy(TM) Monitor, GE Healthcare, Finland), indices as measures of moderate ("conscious") sedation in healthy adult patients receiving a low dose propofol infusion. Sedation was evaluated using: (I) the responsiveness component of the OAA/S scale (Observer's Assessment of Alertness/Sedation scale) and (II) multi-channel electroencephalogram (EEG) interpretation by a clinical expert. METHODS: 12 ASA I patients were recruited. A target-controlled infusion of propofol was administered (using Schnider's pharmacokinetic model) with an initial effect site concentration set to 0.5 microg ml(-1). A 4 minute equilibrium period was allowed. This concentration was increased at 4 minute intervals by 0.5 microg ml(-1) to a maximum of 2.0 microg ml(-1). State (SE) and Response (RE), entropy values were recorded for each 4 minute epoch together with clinical sedation scores (OAA/S) and continuous multi-channel EEG. The multi-channel EEG recorded during the final minute of each 4 minute epoch or "patient/time unit" was presented to a neurophysiologist who assigned a label "sedated/not sedated". SE/RE values were compared in patient/time units with clinical or EEG evidence of sedation versus those without. RESULTS: Mean SE and RE values were less in patient/time units when clinical evidence of sedation was present, [mean = 86.8 (95% CI, 84.0-88.3) and 94.3 (95%CI, 92-96.1)], P = 0.002 and P = 0.001, respectively. In patient/time units assigned the label "sedated" by the clinical neurophysiologist assessing the multi-channel EEG, SE and RE values were less [mean = 87.5 (95% CI, 86.3-88.4) and 95.0 (95% CI, 93.8-96.1)] P = 0.001 and P < 0.001, respectively. CONCLUSIONS: A statistically significant decrease in SE and RE values was demonstrated in patient/time units in which clinical or EEG evidence of sedation was present. We conclude that spectral entropy offers potential as a monitor of propofol induced sedation.
Language:
eng
MeSH:
Adult; Anesthetics, Intravenous/administration & dosage; Awareness/drug effects; *Conscious Sedation/methods; Consciousness/*drug effects; Dose-Response Relationship, Drug; Drug Monitoring/methods; Electroencephalography; Entropy; Humans; Infusions, Intravenous; Judgment/drug effects; Middle Aged; Monitoring, Intraoperative/*methods; Neurophysiology; Predictive Value of Tests; Propofol/*administration & dosage; Weights and Measures
ISSN:
1387-1307 (Print); 1387-1307 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorMahon, Padraigen_GB
dc.contributor.authorKowalski, Robert Gen_GB
dc.contributor.authorFitzgerald, Anthony Pen_GB
dc.contributor.authorLynch, Elaine Men_GB
dc.contributor.authorBoylan, Geraldine Ben_GB
dc.contributor.authorMcNamara, Brianen_GB
dc.contributor.authorShorten, George Den_GB
dc.date.accessioned2012-02-03T15:15:07Z-
dc.date.available2012-02-03T15:15:07Z-
dc.date.issued2012-02-03T15:15:07Z-
dc.identifier.citationJ Clin Monit Comput. 2008 Apr;22(2):87-93. Epub 2008 Feb 6.en_GB
dc.identifier.issn1387-1307 (Print)en_GB
dc.identifier.issn1387-1307 (Linking)en_GB
dc.identifier.pmid18253846en_GB
dc.identifier.doi10.1007/s10877-008-9109-0en_GB
dc.identifier.urihttp://hdl.handle.net/10147/209208-
dc.description.abstractOBJECTIVE: The aim of this prospective, observational study was to evaluate State and Response entropy (Entropy(TM) Monitor, GE Healthcare, Finland), indices as measures of moderate ("conscious") sedation in healthy adult patients receiving a low dose propofol infusion. Sedation was evaluated using: (I) the responsiveness component of the OAA/S scale (Observer's Assessment of Alertness/Sedation scale) and (II) multi-channel electroencephalogram (EEG) interpretation by a clinical expert. METHODS: 12 ASA I patients were recruited. A target-controlled infusion of propofol was administered (using Schnider's pharmacokinetic model) with an initial effect site concentration set to 0.5 microg ml(-1). A 4 minute equilibrium period was allowed. This concentration was increased at 4 minute intervals by 0.5 microg ml(-1) to a maximum of 2.0 microg ml(-1). State (SE) and Response (RE), entropy values were recorded for each 4 minute epoch together with clinical sedation scores (OAA/S) and continuous multi-channel EEG. The multi-channel EEG recorded during the final minute of each 4 minute epoch or "patient/time unit" was presented to a neurophysiologist who assigned a label "sedated/not sedated". SE/RE values were compared in patient/time units with clinical or EEG evidence of sedation versus those without. RESULTS: Mean SE and RE values were less in patient/time units when clinical evidence of sedation was present, [mean = 86.8 (95% CI, 84.0-88.3) and 94.3 (95%CI, 92-96.1)], P = 0.002 and P = 0.001, respectively. In patient/time units assigned the label "sedated" by the clinical neurophysiologist assessing the multi-channel EEG, SE and RE values were less [mean = 87.5 (95% CI, 86.3-88.4) and 95.0 (95% CI, 93.8-96.1)] P = 0.001 and P < 0.001, respectively. CONCLUSIONS: A statistically significant decrease in SE and RE values was demonstrated in patient/time units in which clinical or EEG evidence of sedation was present. We conclude that spectral entropy offers potential as a monitor of propofol induced sedation.en_GB
dc.language.isoengen_GB
dc.subject.meshAdulten_GB
dc.subject.meshAnesthetics, Intravenous/administration & dosageen_GB
dc.subject.meshAwareness/drug effectsen_GB
dc.subject.mesh*Conscious Sedation/methodsen_GB
dc.subject.meshConsciousness/*drug effectsen_GB
dc.subject.meshDose-Response Relationship, Drugen_GB
dc.subject.meshDrug Monitoring/methodsen_GB
dc.subject.meshElectroencephalographyen_GB
dc.subject.meshEntropyen_GB
dc.subject.meshHumansen_GB
dc.subject.meshInfusions, Intravenousen_GB
dc.subject.meshJudgment/drug effectsen_GB
dc.subject.meshMiddle Ageden_GB
dc.subject.meshMonitoring, Intraoperative/*methodsen_GB
dc.subject.meshNeurophysiologyen_GB
dc.subject.meshPredictive Value of Testsen_GB
dc.subject.meshPropofol/*administration & dosageen_GB
dc.subject.meshWeights and Measuresen_GB
dc.titleSpectral entropy as a monitor of depth of propofol induced sedation.en_GB
dc.contributor.departmentDepartment of Anaesthesia and Intensive Care Medicine, Cork University Hospital, , University College Cork, Cork, Ireland. rsimahon@hotmail.comen_GB
dc.identifier.journalJournal of clinical monitoring and computingen_GB
dc.description.provinceMunster-
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